Publication:

Eclampsia: an enigma

Background Eclampsia is the commonest cause of convulsions in pregnancy next being epilepsy. Incidence varies from 1 in 100 to 1 in 2000 pregnancies. Eclampsia accounts for 24% of all maternal deaths in India. Eclampsia is a significant cause of perinatal mortality and morbidity in non-industrialised countries (up to 40% perinatal deaths).

Methods We are reporting a retrospective study on the patients of eclampsia attending a tertiary care hospital. The study included 3907 deliveries conducted in VCSG Govt. Medical Science & Research Institute, Srinagar, Pauri Garhwal, Uttarakhand from April 2012 to Sep. 2014.

Results The total number of eclampsia cases was 98. The antepartum eclampsia cases were 87 and the postpartum eclampsia cases were 11.The incidence of antepartum eclampsia was 2.22% (87/3907) at our center. The total number of maternal deaths due to eclampsia was 6. The total Case Fatality Rate was 11.11% (6/57). There were 6 early neonatal deaths most commonly due to prematurity. There were 20 (22.99%) intrauterine deaths.

Conclusions Early prediction and diagnosis requires high index of suspicion and comprehensive training of health professionals at all levels of health care. The answer to poor management of eclampsia lies in better education and training of all obstetricians, anesthetists, midwives, and general practitioners in the diagnosis and treatment of severe pre-eclampsia and eclampsia.